• 제목/요약/키워드: 서울대학교병원

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Diagnostic Evaluation of the BioFire® Meningitis/Encephalitis Panel: A Pilot Study Including Febrile Infants Younger than 90 Days (BioFire® Meningitis/Encephalitis Panel의 진단적 유용성 평가: 90일 미만 발열영아에서의 예비 연구)

  • Kim, Kyung Min;Park, Ji Young;Park, Kyoung Un;Sohn, Young Joo;Choi, Youn Young;Han, Mi Seon;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.28 no.2
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    • pp.92-100
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    • 2021
  • Purpose: Rapid detection of etiologic organisms is crucial for initiating appropriate therapy in patients with central nervous system (CNS) infection. This study aimed to evaluate the diagnostic value of the BioFire® Meningitis/Encephalitis (ME) panel in detecting etiologic organisms in cerebrospinal fluid (CSF) samples from febrile infants. Methods: CSF samples from infants aged <90 days who were evaluated for fever were collected between January 2016 and July 2019 at the Seoul National University Children's Hospital. We performed BioFire® ME panel testing of CSF samples that had been used for CSF analysis and conventional tests (bacterial culture, Xpert® enterovirus assay, and herpes simplex virus-1 and -2 polymerase chain reaction) and stored at -70℃ until further use. Results: In total, 72 (24 pathogen-identified and 48 pathogen-unidentified) CSF samples were included. Using BioFire® ME panel testing, 41 (85.4%) of the 48 pathogen-unidentified CSF samples yielded negative results and 22 (91.7%) of the 24 pathogen-identified CSF samples yielded the same results (enterovirus in 19, Streptococcus agalactiae in 2, and Streptococcus pneumoniae in 1) as those obtained using the conventional tests, thereby resulting in an overall agreement of 87.5% (63/72). Six of the 7 pathogen-unidentified samples were positive for human parechovirus (HPeV) via BioFire® ME panel testing. Conclusions: Compared with the currently available etiologic tests for CNS infection, BioFire® ME panel testing demonstrated a high agreement score for pathogen-identified samples and enabled HPeV detection in young infants. The clinical utility and cost-effectiveness of BioFire® ME panel testing in children must be evaluated for its wider application.

A Clinically, Radiologically Malignant, but Histopathologically Benign Lesion in Oral Cavity (구강내 발생한 임상적, 방사선학적 악성 및 조직병리학적 양성 병소)

  • Oh, Hyun Jun;Jeon, Jae-ho;Myoung, Hoon
    • The Korean Journal of Oral and Maxillofacial Pathology
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    • v.42 no.6
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    • pp.199-204
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    • 2018
  • Differential diagnosis of the malignant lesion and the benign lesion is critically important for the precise treatment. A clinician should diagnose in a comprehensive manner considering clinical, radiological, and histopathological perspectives. The lesion in the oral cavity in this study was clinically and radiologically malignant. However, the lesion was histopathologically benign. Surgical intervention was not performed except biopsy. The lesion improved after about one month of supportive medication after the biopsy. The importance of decision making process was emphasized in this report.

A Case of Supraglottic Inverted Papilloma (후두 성문상부에 발생한 반전성 유두종 1예)

  • Kim, Doyeon;Kim, Yong Han;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.78-82
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    • 2020
  • Inverted papilloma is a rare benign tumor which usually arises from sinonasal mucosa. We experienced a case of 62-year-old male who presented with foreign body sensation in throat. A round mass was found at right false vocal cord in laryngoscopic examination. It was excised in laryngeal microsurgery. The pathologic diagnosis was inverted papilloma of false vocal cord. Recurrence or complication did not occur during the follow up period of three months.

A Case of Spontaneous Cervical Hematoma caused by Parathyroid Adenoma (부갑상선 선종으로 인한 자발적 경부 혈종 1예)

  • Jeon, Gyeong Hwa;Oh, Hyeon Seok;Byeon, Hyung Kwon
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.101-104
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    • 2021
  • Spontaneous cervical hematomas could lead to life-threatening complications, and aneurysms, retopharyngeal abscesses, parathyroid adenomas, laryngeal cysts, and neurogenic tumors should be distinguished as possible underlying causes. Symptoms accompanying spontaneous cervical hematoma include cervical swelling, ecchymosis, dysphagia, dyspnea and hoarseness. We recently experienced a case of spontaneous cervical hematoma in a 52-year-old woman, who initially presented with cervical swelling after severe coughing two days ago. Resultingly parathyroid adenoma was finally confirmed after mass excision. Therefore, we present this unique case with a review of the literature.

Arthroscopy for Rotational Ankle Fractures (회전형 발목 골절에서 관절경의 역할)

  • Tae Hun Kwon;Yoon Hyo Choi;Kyoung Min Lee
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.1
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    • pp.7-11
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    • 2023
  • Rotational ankle fractures are one of the most common injuries of lower limbs treated by orthopedic surgeons. Open reduction and internal fixation (ORIF) is considered a gold standard treatment for unstable ankle fractures, though adjunct ankle arthroscopy is being increasingly used in cases of ankle trauma. Although the role and use of ankle arthroscopy are expanding, the clinical outcomes and cost-effectiveness of arthroscopy remain undefined. Furthermore, despite the number of clinical research studies performed on arthroscopically assisted surgery for ankle fractures, no definite guidelines have been agreed, and no consensus has been reached regarding indications. This article reviews the role, indications, operative techniques, and complications of ankle arthroscopy and compares the clinical outcomes of conventional ORIF and arthroscopically assisted ORIF.

Clinical Implication and Proposed Mechanism of Direction Changing Vibration Induced Nystagmus in Unilateral Vestibular Hypofunction (일측 전정기능 저하 환자에서 방향전환 진동유발안진의 임상적 의의와 발생 기전 제안)

  • Lee, Dong Han;Park, Moo Kyun;Lee, Jun Ho;Oh, Seung-Ha;Suh, Myung-Whan
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.11
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    • pp.580-587
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    • 2018
  • Background and Objectives We evaluated the clinical characteristics and vestibular function of patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibular hypofunction and suggest clinical implication and a proposed mechanism of DC VIN. Subjects and Method The records of 315 patients who underwent the VIN test were reviewed retrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15 patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair (RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN and the dizziness characteristics, duration of disease, and the outcome of the vestibular function test. Results The mean age of 15 patients was $67.4{\pm}10.7years$ and the mean duration of dizziness was $13.6{\pm}29.7months$. The caloric test revealed 25% of the patients to have significant canal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT (Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) and eight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateral DC VIN were shown to have a significant longer duration of dizziness than those with contralateral DC VIN. Conclusion Although rare, DC VIN can also be found in patients with unilateral vestibular hypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VN or Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems to be due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuation of vibration.

Revision after Instability Surgery (수술 후 재발한 견관절 불안정증의 치료)

  • Kim, Paul Shinil;Jo, Chris Hyunchul
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.374-382
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    • 2020
  • Recurrence is the most common complication after shoulder instability surgery, and the main causes of the postoperative recurrence of instability are trauma, misdiagnosis, and technical errors. The risk factors of recurrence may be classified as patient related, anatomical or technical. Causes of failure should be thoroughly evaluated by meticulous history taking, physical examination, and imaging studies, and followed by proper treatment of pathologic lesions. Nonoperative treatment should be considered initially in cases of recurred instability after shoulder instability surgery, but if this fails, repeated recurrence is prevented by performing appropriate anatomical reconstruction of ruptured Bankart lesions, capsular laxities, glenoid deficiencies and humeral head bone defects.

Genetic Association Study of the Common Genetic Variation of Early Growth Response 3 Gene With Bipolar Disorder in Korean Population (Early Growth Response 3 유전자와 양극성 장애 간 유전연합 연구)

  • Jang, Moonyoung;Ahn, Yong Min;Kim, Yong Sik;Kim, Se Hyun
    • Korean Journal of Biological Psychiatry
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    • v.29 no.2
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    • pp.33-39
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    • 2022
  • Objectives The early growth response 3 (EGR3) gene located in chromosome 8p21.3 is one of the susceptibility loci in many psychiatric disorders. EGR3 gene plays critical roles in signal transduction in the brain, which is involved in neuronal plasticity, neuronal development, learning, memory, and circadian rhythms. Recent studies have suggested EGR3 as a potential susceptibility gene for bipolar disorder (BPD). However, this requires further replication with an independent sample set. Methods To investigate the genetic role of EGR3 in Korean patients, we genotyped six single-nucleotide polymorphisms (SNPs) in the chromosome region of EGR3 in 1076 Korean BPD patients and 773 healthy control subjects. Results Among the six examined SNPs of EGR3 (rs17088531, rs1996147, rs3750192, rs35201266, rs7009708, rs1008949), SNP rs35201266, rs7009708, rs1008949 showed a significant association with BPD (p = 0.0041 for rs35201266 and BPD2, p = 0.0074 for rs1008949 and BPD, p = 0.0052 for rs1008949 and BPD1), which withstand multiple testing correction. In addition, the 'G-C-C-C' and 'G-C-G-C' haplotypes of EGR3 were overrepresented in the patients with BPD (p = 0.0055, < 0.0001, respectively) and the 'G-T-G-C' haplotype of EGR3 was underrepresented in patients with BPD (p = 0.0040). Conclusions In summary, our study supports the association of EGR3 with BPD in Korean population sample, and EGR3 could be suggested as a compelling susceptibility gene in BPD.

Egress Safety of Nursing Hospital Considering Egress Guides and Smoke Exhaust System (피난유도자 수와 배연설비를 고려한 요양병원의 피난안전성 평가)

  • Choi, Seung-Ho;Darkhanbat, Khaliunaa;Heo, Inwook;Kim, Kang Su
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.26 no.3
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    • pp.64-71
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    • 2022
  • In this study, fire and egress simulation was conducted for the egress safety evaluation of the nursing hospitals. A fire simulation was performed with or without the smoke exhaust system using the FDS, and the available safe egress time (ASET) of the nursing hospitals was calculated. In addition, an egress simulation considering the characteristics of occupants and egress delay time was performed using Pathfinder, and the required safe egress time (RSET) was calculated. By comparing the ASET and RSET, the egress safety of the nursing hospital with or without a smoke exhaust system was evaluated according to the number of egress guides and the egress delay time. The simulation results show that the number of casualties increased as the egress delay time increased, and the required safe egress time decreased as the number of egress guides increased. In addition, it was found that if a smoke exhaust system with the capacity specified in the KFPA is secured, the available safe egress time can be greatly increased and the number of casualties can be greatly reduced.

Beyond Coronary CT Angiography: CT Fractional Flow Reserve and Perfusion (전산화단층촬영 관상동맥조영술: 분획혈류예비력과 심근관류 영상)

  • Moon Young Kim;Dong Hyun Yang;Ki Seok Choo;Whal Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.3-27
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    • 2022
  • Cardiac CT has been proven to provide diagnostic and prognostic evaluation of coronary artery disease for cardiovascular risk stratification and treatment decision-making based on rapid technological development and various research evidence. Coronary CT angiography has emerged as a gateway test for coronary artery disease that can reduce invasive angiography due to its high negative predictive value, but the diagnostic specificity is relatively low. However, coronary CT angiography is likely to overcome its limitations through functional evaluation to identify the hemodynamic significance of coronary artery disease by analyzing myocardial perfusion and fractional flow reserve through cardiac CT. Recently, studies have been actively conducted to incorporate artificial intelligence to make this more objective and reproducible. In this review, functional imaging techniques of cardiac computerized tomography are explored.